A change of IL-2 and IL-4 production in patients with Helicobactor pylori infection

Hellcobacter pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.     

Effect of cagA status on the sensitivity of enzyme immunoassay in diagnosing Helicobacter pylori-infected children

Background. The aims of our study were twofold. First, we sought to evaluate in symptomatic children the influence of the Helicobacter pylori genotype on gastritis, abdominal pain, and circulating anti– H. pylori IgG antibodies (anti– H. pylori IgG) or pepsinogen A (PGA) and C (PGC). Additionally, we sought to assess anti– H. pylori IgG, PGA, and PGC patterns in a large cohort (N = 921) of asymptomatic children.
Materials and Methods. In 183 symptomatic children, H. pylori infection and the presence of gastritis were evaluated by histology. In a subgroup of 20 H. pylori –positive children, the H. pylori genotype was evaluated also by polymerase chain reaction. Nine hundred and twenty-one asymptomatic children, aged 11 to 14 years, were studied by anti– H. pylori IgG, PGA, and PGC serum determination.
Results. The infection was found in 33 of 183 symptomatic children; among the 20 H. pylori –positive children for which the H. pylori genotype was available, cag A was present or absent in equal percentages. H. pylori infection was associated with more severe gastritis and higher serum levels of anti– H. pylori IgG and PGC but not with abdominal pain. In infected children, higher levels of anti– H. pylori IgG and the presence of abdominal pain were associated with infections caused by cag A-positive strains. In the cohort of 921 asymptomatic children, raised levels of anti– H. pylori IgG, PGA, and PGC were found in approximately 5% of the cases.
Conclusions. Infection with cag A-positive H. pylori strains can be associated with increased frequency of reported abdominal pain and higher circulating levels of anti– H. pylori IgG. The serological assessment of H. pylori IgG using H. pylori antigens containing significant amounts of cagA protein may, therefore, underestimate the true prevalence of infection.     

幽门螺杆菌在胃内定植的相关影响因素

胃内定植是引起幽门螺杆菌(Helicobacter pylori,H.pylori)感染的先决条件。H.pylori可穿过胃黏液层并与胃上皮细胞相互作用。这个定植过程主要受到H.pylori动力和尿素酶的影响。同时H.pylori形态、胃内pH、外膜蛋白及益生菌等也在其中扮演重要角色。该研究主要对H.pylori胃内定植过程中的相关影响因素进行综述。     

幽门螺旋菌感染血清学诊断

运用建立起来的酶联免疫吸附试验对80名胃镜确诊胃炎及消化性溃疡患者的血清中抗幽门螺旋菌(Helicobacter pylori)IgG、IgA IgM进行了检测。结果表明,抗H.pylori IgG、IgA都可作为H.pylori感染的指标,但前者敏感性较好(92.0%),后者特异性较高(94.4%);抗H.pyloriIgM升高和降低与H.pylori感染无明显关系。抗H.pylori IgG、IgA水平与H.py     

Long-term follow up of Helicobacter pylori IgG serology after eradication and reinfection rate of H. pylori in South Korea

Background: Serology is widely used for epidemiologic research of Helicobacter pylori . However, there is limited information on the long-term follow up of H. pylori titers after eradication. In addition, it is presumed that the reinfection rate decreases as the H. pylori infection rate decreases. The aim of this study was to investigate the long-term follow up of H. pylori IgG, and to evaluate the reinfection rate of H. pylori in Korea.
Methods: Among 247 patients, who were enrolled during 2003–07, 185 patients with invasive H. pylori test positive received proton pump inhibitor-based triple therapy, and follow-up H. pylori testing, including histology, CLOtest, culture, and serology, were evaluated 2, 10, and 18 months after H. pylori eradication.
Results: The initial H. pylori IgG optical density (OD_450nm), 2.06, gradually decreased to 0.63 (67% reduction) at 18 months after H. pylori eradication. The seroreversion rate was 5, 10, and 45% at 2, 10, and 18 months after H. pylori eradication, respectively. The recrudescence of H. pylori was 3.49%, and the annual reinfection rate was 2.94% per year. H. pylori IgG titers abruptly increased in cases with recrudescence and reinfection, and correlated with the results of the invasive H. pylori tests.
Conclusion: The results of this study showed that H. pylori IgG serology could be used for the determination of reinfection of H. pylori, but not for the diagnosis of H. pylori eradication. The reinfection rate of H. pylori , in Korea, was found to be very low, 2.94% per year.     

不同类型幽门螺杆菌对GES-1细胞Cx32、Cx43表达的影响

目的观察不同类型幽门螺杆菌（Helicobacter pylori,H.pylori）对人胃黏膜上皮细胞系GES-1细胞间隙连接蛋白（Connexin,Cx）32和43表达的影响,探讨与Cx32、Cx43表达异常有关的H.pylori菌株类型。方法将临床培养分离的不同H.pylori菌株类型包括东亚型CagA＋H.pylori、西方型CagA＋H.pylori及CagA-H.pylori与GES-1细胞共培养24 h及48 h,对照组不加H.pylori培养24 h及48 h。采用间接免疫荧光方法（IIF）及计算机图像分析技术检测GES-1细胞Cx32、Cx43表达。结果对照组24 h和48 h及加H.pylori各组24 h GES-1细胞Cx32、Cx43表达阳性率均为100%,东亚型CagA＋H.pylori组48 h Cx32、Cx43表达阳性率均低于对照组、CagA-H.pylori组和西方型CagA＋H.pylori组（P〈0.05）;对照组24 h和48 h Cx32、Cx43绿色荧光位于细胞膜,西方型CagA＋H.pylori组和东亚型CagA＋H.pylori组24 h和48 h Cx32绿色荧光大部分位于细胞膜,少部分位于细胞浆,Cx43绿色荧光大部分位于细胞浆,少部分位于细胞膜;东亚型CagA＋H.pylori组和西方型CagA＋H.pylori组24 h及48 hCx32、Cx43表达强度低于对照组和CagA-H.pylori组（P〈0.05）,且东亚型CagA＋H.pylori组较西方型CagA＋H.py-lori组减弱更明显（P〈0.05）。结论 H.pylori下调GES-1细胞Cx32、Cx43表达,以CagA＋H.pylori菌株特别是东亚型CagA＋H.pylori菌株作用更明显。     

Characterization of a culture method to recover Helicobacter pylori from the feces of infected patients

Background. Helicobacter pylori is difficult to culture from stool. Multiple efforts from multiple laboratories have been unsuccessful, and the optimal conditions to recover H. pylori from stool are still not known. Recovery of H. pylori from feces of infected individuals is important for the performance of molecular epidemiological investigations, especially in children, where their symptoms do not warrant endoscopy to recover the organism.
Methods. Fresh fecal specimens (noncathartic) were obtained from 19 known H. pylori –infected patients and were processed to recover the organism. Fresh fecal specimens (noncathartic) were also obtained from three known H. pylori –negative individuals (controls) to determine whether H. pylori could be isolated from stools seeded with known concentrations of the organism. Treatment of the fecal suspensions with cholestyramine, a basic anion exchange resin that binds bile acids, was used in an attempt to enhance recovery of H. pylori by sequestering bile acids that are inhibitory to H. pylori growth. H. pylori was identified based on colony morphology, cell morphology, Gram's stain, biochemical reactions, and polymerase chain reaction for two H. pylori genes.
Results. Among 19 patients, H. pylori was cultured at least once from 3 and three times from 2 (5 of 19). Feces that were seeded with H. pylori and obtained from three H. pylori –negative volunteer controls yielded positive recovery in all instances.
Conclusion. We have confirmed that it is possible to culture H. pylori from human stool, but the procedure for optimal recovery has still not been defined.     

Combined effect of rebamipide and ecabet sodium on Helicobacter pylori adhesion to gastric epithelial cells

Helicobacter pylori is a major etiological agent in gastroduodenal disorders. The adhesion of H. pylori to gastric epithelial cells is the initial step of H. pylori infection. Inhibition of H. pylori adhesion is thus a therapeutic target in the prevention of H. pylori infection. We have reported that rebamipide and ecabet sodium, mucoprotective antiulcer agents, independently inhibit H. pylori adhesion. However, the antiadhesion activity of each antiulcer agent was incomplete. Experiments were performed to evaluate the combined effect of rebamipide and ecabet sodium on H. pylori adhesion to gastric epithelial cells. MKN-28 and MKN-45 cells, derived from human gastric carcinomas, were used as target cells. Twelve clinical isolates of H. pylori were used in this study. We evaluated the effects of rebamipide and ecabet sodium, individually and in combination, on H. pylori adhesion to target cells quantitatively using our previously established enzyme-linked immunosorbent assay. Rebamipide and ecabet sodium each partially inhibited H. pylori adhesion. In contrast, adhesion was almost completely inhibited by pretreating target cells and H. pylori with the combination of rebamipide and ecabet sodium. Our studies suggest that the synergistic antiadhesion activity of rebamipide and ecabet sodium is greater than that of each antiulcer agent alone.     

汉中市汉台区无症状儿童幽门螺杆菌感染率的 流行病学调查

目的研究陕西省汉中地区无症状儿童幽门螺杆菌(H.pylori)感染的流行病学特点及其影响因素。方法采用酶联免疫吸附法(ELISA)检测2013年1月至2018年1月间我院328例无消化道症状儿童Hp-IgG水平情况,分析其流行病学特点,并行问卷调查研究幽门螺杆菌感染的影响因素。结果 328例无消化道症状儿童H.pylori感染率为18.90%。其中男童169例,感染率21.89%;女童159例,感染率15.72%;城市儿童137例,感染率20.44%;农村儿童191例,感染率17.80%。经Logstic回归分析,年龄3～4岁、饭前便后洗手、父母具有大学文化水平均为H.pylori感染的保护性因素;啃手指、公用洗漱杯、直系亲属胃病史均为H.pylori感染的独立危险因素,差异均有统计学意义(P0.05)。结论 H.pylori感染在儿童中较为常见,生活中不良习性与H.pylori感染密切相关。H.pylori感染相关高危因素的分析对于儿童H.pylori感染的防控具有重要临床意义。     

胃息肉与幽门螺杆菌感染关系研究

目的探讨胃息肉与幽门螺杆菌（Helicobacter pylori,H.pylori）感染关系。方法对1218例胃息肉同时进行H．pylori检查患者进行回顾性分析,分析胃息肉患者H.pylori感染率、胃息肉部位与H.pylori感染关系、胃息肉病理类型与H.pylori感染关系。结果发现胃息肉Hpylori感染患者532例,Hpylori感染率为43．7％。男性胃息肉患者H.pylori感染率为47．5％（216／455）,女性Hpriori感染率感染率为41．4％（316／763）（P〉0．05）,年龄〈20岁、20～39岁、40—59岁和≥60岁胃息肉H.priori感染率分别为41．7％、44．7％、41．6％和47．2％（P〉0．05）;胃窦胃角息肉H.pylori感染率高于其他部位（胃体、胃底和贲门）（P〈0．05）;炎性和增生性胃息肉H.priori感染率高于胃底腺和腺瘤性息肉（P〈0．05）。结论H.pylori感染可能与部分胃息肉发生有一定关系,需要进一步深入研究胃息肉的发生机制。     

应用生物信息学方法筛选幽门螺杆菌疫苗候选抗原

目的：应用生物信息学分析方法筛选幽门螺杆菌新的疫苗候选抗原。方法：从TIGRCMR下载幽门螺杆菌26695和J99株全基因组序列,应用生物信息学SignalP、PredTMBB、LipoP、TMHMM、Phobius、PSORT-B和SubLoc等分析软件,筛选幽门螺杆菌新的外膜蛋白和分泌蛋白疫苗候选抗原。结果：从幽门螺杆菌26695株筛选得到54个编码β-桶型跨膜蛋白、脂蛋白或分泌表达蛋白的疫苗候选蛋白抗原,从幽门螺杆菌J99株得到61个呈现上述表达方式的疫苗候选蛋白抗原;且这2株细菌的疫苗候选蛋白呈现良好的交集状况,即有43个候选疫苗蛋白是相同的。结论：用生物信息学分析方法可以从全基因组范围内快速筛选到保守的分泌或表面暴露的疫苗候选抗原,为疫苗抗原的快速筛选与鉴定奠定了基础。     

L-lactic acid secreted from gastric mucosal cells enhances growth of Helicobacter pylori

BACKGROUND: Helicobacter pylori mainly inhabit the mucus layer in the gastric mucosa. However, mechanisms involving H. pylori colonization and proliferation in gastric mucosa are not well established. This study focuses on elucidating the role of gastric mucosal cells on growth of H. pylori. MATERIALS AND METHODS: H. pylori was co-cultured with the murine gastric surface mucosal cells (GSM06), and the growth of H. pylori on the cells was assessed by enumerating the colony-forming units (CFU). The H. pylori growth factor in the culture media conditioned by GSM06 cell was purified by HPLC, and the chemical structure of the growth factor was identified by analyses of (1)H- and (13)C-NMR spectra. RESULTS: A marked increase in the number of CFU of H. pylori was observed in the GSM06 cells. The enhanced H. pylori growth was also observed when indirectly incubated with GSM06 cells through semi-permeable membrane. In addition, culture media conditioned by GSM06 cell stimulated H. pylori growth approximately one thousand-fold. By bioassay-guided purification, the H. pylori growth factor was isolated from the conditioned medium of GSM06 cells and identified as L-lactic acid. The H. pylori growth-enhancing activity under microaerobic condition was well correlated with L-lactic acid concentrations in the conditioned media. CONCLUSIONS: This study demonstrates that L-lactic acid secreted by gastric mucosal cells enhances the growth of H. pylori, and this L-lactic acid-dependent growth of H. pylori may be important to the long-term colonization of H. pylori in the stomach.     

Effect of Helicobacter pylori eradication on extent of duodenal gastric metaplasia and grade of gastritis

The extent of the regression of duodenal gastric metaplasia (DGM) after the eradication of Helicobacter pylori infection is controversial. Therefore, we decided to assess the degree of DGM before, sex weeks and one year after H. pylori eradication. 105 consecutive Helicobacter pylori positive patients with endoscopically proven duodenal ulcer, with DGM and Helicobacter pylori infection were recruited for this study. The diagnosis of Helicobacter pylori infection was based on CLO-test and histology, and DGM was assessed on four bulb biopsies taken before, sex weeks and one year after Helicobacter pylori eradication. Histological assessment of Helicobacter pylori associated gastritis was performed according to the Sydney classification. Follow up study on 98 patients before, six weeks and one year after the eradication of Helicobacter pylori showed that the mean extent of DGM did not change significantly after eradication and did not differ when compared with 14 patients with persisting infection. Our results show that the inflammatory process related to Helicobacter pylori does not play the main role in the development of DGM.     

Docosahexaenoic acid inhibits Helicobacter pylori growth in vitro and mice gastric mucosa colonization

H. pylori drug-resistant strains and non-compliance to therapy are the major causes of H. pylori eradication failure. For some bacterial species it has been demonstrated that fatty acids have a growth inhibitory effect. Our main aim was to assess the ability of docosahexaenoic acid (DHA) to inhibit H. pylori growth both in vitro and in a mouse model. The effectiveness of standard therapy (ST) in combination with DHA on H. pylori eradication and recurrence prevention success was also investigated. The effects of DHA on H. pylori growth were analyzed in an in vitro dose-response study and n in vivo model. We analized the ability of H. pylori to colonize mice gastric mucosa following DHA, ST or a combination of both treatments. Our data demonstrate that DHA decreases H. pylori growth in vitro in a dose-dependent manner. Furthermore, DHA inhibits H. pylori gastric colonization in vivo as well as decreases mouse gastric mucosa inflammation. Addition of DHA to ST was also associated with lower H. pylori infection recurrence in the mouse model. In conclusion, DHA is an inhibitor of H. pylori growth and its ability to colonize mouse stomach. DHA treatment is also associated with a lower recurrence of H. pylori infection in combination with ST. These observations pave the way to consider DHA as an adjunct agent in H. pylori eradication treatment.     

幽门螺杆菌在牙菌斑及胃粘膜分布研究

目的:探讨幽门螺杆菌(Helicobacter pylori,Hp)在牙菌斑及胃粘膜分布状况。方法:采用聚合酶链式反应(polym erase chain reaction,PCR)技术对80 例慢性胃溃疡患者的牙菌斑及胃粘膜组织进行Hp 检测。结果:48 例胃粘膜Hp 阳性的患者中12 例牙菌斑Hp 阳性;胃粘膜Hp 阴性的患者无一例牙菌斑Hp 阳性;胃Hp 阳性检出率大于牙菌斑。结论:幽门螺杆菌不仅存在于胃粘膜组织中,也存在于口腔牙周组织中。提示牙菌斑可能是Hp 的重要寄居地。     

Helicobacter pylori and Schistosoma japonicum co-infection in a Chinese population: helminth infection alters humoral responses to H. pylori and serum pepsinogen I/II ratio

The effects of helminth infection on humoral IgG responses and clinical outcome of gastric Helicobacter pylori infection are unknown. IgG and IgG subclass responses to H. pylori and serum pepsinogen I/II ratio, a marker of gastric atrophy, were investigated in a Schistosoma japonicum prevalent Chinese population. H. pylori, CagA and IgG subclass responses were assayed by ELISA. Serum pepsinogen I and pepsinogen II were assayed by ELISA and the pepsinogen I/II ratio determined. In 150 subjects, infection with S. japonicum and H. pylori was 55.3% and 51.3%, respectively. H. pylori IgG titres and CagA seropositivity were significantly lower (P<0.05) in co-infected subjects, and differences in H. pylori IgG isotype responses were evident. In H. pylori positives, a significantly higher (P<0.05) pepsinogen I/II ratio was observed in co-infected subjects. The difference between S. japonicum positive and negative subjects was only evident in H. pylori CagA seronegative subjects. In conclusion, S. japonicum co-infection with H. pylori is associated with alterations in IgG responses to H. pylori and less gastric atrophy.     

幽门螺杆菌外膜囊泡研究进展

幽门螺杆菌(Helicobacter pylori)被认为是引起人类胃部疾病的元凶之一。外膜囊泡(Outer Membrane Vesicles,OMVs)是由细菌外膜自发脱落而形成的囊泡状结构,其具有细菌外膜多数成分,包括外膜蛋白、多糖、脂质以及其他蛋白组分。越来越多的研究正在关注外膜囊泡在幽门螺杆菌感染、发生、发展过程中的作用。同时,研究表明幽门螺杆菌外膜囊泡作为疫苗,在防治幽门螺杆菌感染中也展现了良好的应用潜力。因此,本综述总结了目前关于幽门螺杆菌外膜囊泡组成成分的研究,并讨论了外膜囊泡在幽门螺杆菌存活和致病机制中的作用,以及外膜囊泡在幽门螺杆菌感染治疗中发挥的作用。     

Helicobacter pylori: an invading microorganism? A review

In this review we evaluate the pros and cons of Helicobacter pylori invasion of epithelial cells as part of the natural history of H. pylori infection. H. pylori is generally considered an extracellular microorganism. However, a growing body of evidence supports the controversial hypothesis that at least a subset of H. pylori microorganisms has an intracellular (intraepithelial) location. Most significant is the fact that H. pylori invades cultured epithelial cells with invasion frequencies similar to Yersinia enterocolitica and better than Shigella flexneri; furthermore, studies of invasion mechanisms suggest that H. pylori invasion of and survival within epithelial cells is not merely a passive event, but requires active participation of the microorganism. Although many studies of human gastric biopsy specimens have failed to demonstrate any intracellular H. pylori, some studies have revealed a minor fraction of H. pylori inside gastric epithelial cells, with possible linkage to peptic ulceration and epithelial cell damage. In conclusion, these data encourage further research to establish whether intracellular H. pylori does play a role in H. pylori colonization of the human stomach and in peptic ulcer pathogenesis.